Dealing with Initial Denial
Hey BAF!
I was upset to say the least when I got word less than 24 hours from my scheduled revision of a 22 year old VBG to RYN to find out my insurance company denied the procedure. It took me a day to get it together and file my appeal - but I have and I think I have a good argument. My insurance does cover revisional procedures where there is medical necessity that endangers health and my surgeon and I believe based on the totally ruptured staple line, band eroision and mesh embedded in my stomach that I should be covered.
But for those of you who dealt with denials, how did you keep your spirits up? I'm going to fight this but it feels like a real kick in the face.
I was upset to say the least when I got word less than 24 hours from my scheduled revision of a 22 year old VBG to RYN to find out my insurance company denied the procedure. It took me a day to get it together and file my appeal - but I have and I think I have a good argument. My insurance does cover revisional procedures where there is medical necessity that endangers health and my surgeon and I believe based on the totally ruptured staple line, band eroision and mesh embedded in my stomach that I should be covered.
But for those of you who dealt with denials, how did you keep your spirits up? I'm going to fight this but it feels like a real kick in the face.
Honey dip - that insurance company is just doing what it's supposed to. It's a for profit company - so do you REALLY think it's their job to give a frazzle about your HEALTH over their PROFIT?????
Look at it as the first step of what will be YOUR journey. I had three denials and arbitration before approval for my surgery - I just looked at it as my fight to get what's MINE. So, dig in - and steel yourself for more bullshiot on their part. Keep your ducks in a row and realize you are in a standoff. It's their job to say no and your job to tell em they BETTER cover your shiot......
Now let's SEE who works harder at their job.......
Look at it as the first step of what will be YOUR journey. I had three denials and arbitration before approval for my surgery - I just looked at it as my fight to get what's MINE. So, dig in - and steel yourself for more bullshiot on their part. Keep your ducks in a row and realize you are in a standoff. It's their job to say no and your job to tell em they BETTER cover your shiot......
Now let's SEE who works harder at their job.......
I don't just have issues, I have subscriptions! I'm saving on the newsstand price....... 
Check out my dating mis - adventures at: http://1macdatinggame.blogspot.com/
Keep on fighting. These insurance companies are a trip. I was denied by my insurance twice to enter their program for surgery. I had to go through 4 PCP's and 6 months of doing weigh****chers and one nasty letter explaining to them how they were discriminating against me because of my age and other factors. Thats was since 2005 and I finally had surgery 2 months ago. Don't give up. Put your game face on and prepare to go to war.
I agree with both of ladies *****sponded prior to me. I used to have people praying for me everyday because I honestly felt like I was going to lose my freakin' mind. Keep your spirits up.
People are so worried about what they eat between Christmas and the New Year, but they really should be worried about what they eat between the New Year and Christmas. ~Author Unknown
Thanks all! I needed the encouragement. I think I'm right not only should they cover it; my reading of my specific policy and their published policy on bariatric surgery tells me they do cover it - they just don't want to get off the $$$. I've done what I can do right now. I have to stop obsessing over this or I am going to drive myself crazy. Definitely standing in the need of prayer.
Rhonda S.
Rhonda S.
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